Gabriel Perna | October 24, 2019
Google. Amazon. Apple. Microsoft. IBM.
Every big tech company right now is making some kind of move into health care, but what’s behind the sudden rush of new entrants from Silicon Valley?
Eric Schmidt, former Executive Chairman of Google and Alphabet, and John Doerr, Chairman of Kleiner Perkins and a Founding Investor of Google and Amazon, say it’s all about opportunity and data aggregation.
Doerr and Schmidt joined Health Evolution Chairman David Brailer in a discussion about those reasons, why health care deserves the most innovative minds, top priorities today and the need for a platform to facilitate AI, data sharing and value-based care.
Costs of care driving need for innovation
Doerr and Schmidt both say one major reason for this trend is the increasing cost of care ($3.5 trillion in 2017) without the results to show for it.
“The priorities, the ambition, the agenda says that health care deserves the very best of the most innovative minds we have in the country,” said Doerr.
Schmidt added that the rise of EHRs over the past 10 years—since the enactment of the HITECH Act—has aggregated data in the health care system unlike ever before. This has made health care an appetizing market for big tech.
“That early work has created these large data pools that can then be used for diagnostics, for improvements in billing, for efficiencies of systems and for better health care,” Schmidt said.
Moreover, wearables and consumer health data has seen a rush of interest in the last few years. Approximately 24 percent of Americans have wearables, according to a statistic cited by Doerr. Combining clinical and personal data represents an opportunity that is quite simply an enticing opportunity for big tech.
As Brailer noted, the enormous rush of data has yet to come together. “Providers don’t want to touch it because it’s not regulated data and there’s a lot of nervousness about releasing their data out into the wild,” Brailer said. Schmidt added that companies like Google may be able to normalize the data to make it look like it came from one source.
“When you can see a common view of all the data about a patient across all the different providers, you [will] get a huge acceleration,” Schmidt said. Brailer added that he expects a marketplace of data custodians—big tech, payers, other organizations—who will compete over usage of this data.
Coming data quake – and a concern
Market forces alone won’t be enough to normalize the data. Doerr praised Centers for Medicare and Medicaid Services Administrator Seema Verma’s efforts to make Medicare Advantage and Medicaid data available. “She’s going to use every lever at her disposal to have all the data from payers be liberated,” Doerr added.
The efforts from the government, combined with the emerging market forces from big tech, have sparked considerable optimism. “I think what’s going on right now is we’re feeling the early tremors of a data quake,” Doerr added.
What areas of the health care system will benefit from big tech’s emergence into the space? Schmidt pointed to vision systems, such as CAT scans, as a clear-cut opportunity of where AI and data aggregation can play a part in improving diagnosis.
“We can look at a low dosage lung cancer screening, and the computer [generates] an image of the chest cavity in the obvious way. It can identify something that’s unusual. It can then make a decision on its own to look more carefully, try to look for tumors. Think about how useful it would be to have that as the advisor to the physician,” he said.
Schmidt mentioned this impact coming in radiology, pathology, ophthalmology and dermatology. He also sees a world where AI helps mental health professionals, by giving them better data on how certain drugs affect patients.
Despite the potential of AI and big tech, none of these visionaries were ready to foresee a world where computers completely replaced doctors. Schmidt says AI-enabled systems should be advisors to doctors, with the latter keeping a critical eye on what the computer is telling them.
“At the moment, we cannot fully guarantee the accuracy of true AI algorithms. They have unknown errors. That tells me that today, an AI system should not be the last line of defense,” Schmidt said.
One area of potential concern, as Brailer noted, is the different philosophies competing in the health care and big tech universes. Whereas AI is developed in large technology companies that “move fast and break things,” there is a deliberate, scientific process around drugs and procedures in health care.
How do the two sides compromise?
“There has to be a way to experiment without violating the rules and the norms and so forth, but the two have to come together,” Schmidt said. “They cannot be separate.”
Another underlying factor in how this plays out is whether or not it will be done in a value-based environment. Right now, as Doerr noted, health care needs a platform that allows providers and payers to share the same trusted set of data to take a population of patients, risk adjust them, attribute them to the provider and then monitor their progress against that value-based contracts over time.
“This does not exist in our industry today,” Doerr stated.
Watch more highlights from the full discussion in the below video.